Acute and chronic pancreatitis, active component, U.S. Armed Forces, 2004-2018

Area of Science:

• Gastroenterology
• Epidemiology
• Military Health

Background:

• Pancreatitis, an inflammation of the pancreas, presents as acute (AP) or chronic (CP) forms.
• AP involves premature activation of pancreatic digestive enzymes, leading to inflammation.
• Understanding pancreatitis incidence and risk factors in military populations is crucial for public health.

Purpose of the Study:

• To determine the incidence rates and trends of acute pancreatitis (AP) and chronic pancreatitis (CP) in U.S. active component service members.
• To identify demographic and military occupational factors associated with higher AP and CP rates.
• To examine the progression rate from AP to CP within this cohort.

Main Methods:

• Retrospective analysis of incident diagnoses of AP and CP among U.S. active component service members from 2004 to 2018.
• Calculation of crude incidence rates per 100,000 person-years (p-yrs).
• Stratification of rates by demographic (sex, age, race/ethnicity) and military characteristics (branch, occupation).

Main Results:

• A total of 6,471 AP diagnoses occurred, with an overall incidence rate of 31.8 per 100,000 p-yrs.
• AP rates were highest among females, older age groups, non-Hispanic blacks, Army members, and healthcare workers.
• Annual AP rates increased by 25.5% over the study period, driven by outpatient diagnoses. 9.0% of AP cases progressed to CP. CP incidence was 4.4 per 100,000 p-yrs.

Conclusions:

• Acute pancreatitis incidence rose significantly in U.S. service members, with specific demographic and occupational groups at higher risk.
• While a notable percentage of AP cases transitioned to CP, chronic pancreatitis rates remained relatively stable.
• Further research is needed to elucidate risk factors for AP to CP progression, including genetic and environmental interactions.